Healthcare Claim Analyst Jobs in Pennsylvania

13,738 Job Information Deloitte Healthcare Data Analytics & Visualization Consultant ... Visualization Consultant in Harrisburg Pennsylvania Healthcare Data Analytics and Visualization Consultant ... expertise on Medicare (preferably Claims) Healthcare Analytics..

13,738 Job Information Deloitte Healthcare Data Analytics & Visualization Consultant ... Visualization Consultant in Philadelphia Pennsylvania Healthcare Data Analytics and Visualization Consultant ... expertise on Medicare (preferably Claims) Healthcare Analytics..

16,436 Job Information Deloitte Federal Healthcare Data Analytics and Visualization Analyst in Harrisburg Pennsylvania Federal Healthcare Data Analytics and Visualization Analyst Are you a Federal Data ... expertise on Medicare..

Job Information Humana Call Center Pharmacy Claims Technician, Remote in Pittsburgh Pennsylvania Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative ..

Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate ..

Description Job Description Summary The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations ..

... Humana Lead Product Manager - Healthcare API in Pittsburgh Pennsylvania Description ... The Lead Product Manager - Healthcare API (SME) as part of ... Individual will be leveraging previous..

Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..

Job Information Humana Call Center Pharmacy Claims Technician in Pittsburgh Pennsylvania Description Job Description Summary The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in Pittsburgh Pennsylvania Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business ..

16,436 Job Information Deloitte Federal Healthcare Data Analytics and Visualization Analyst in Philadelphia Pennsylvania Federal Healthcare Data Analytics and Visualization Analyst Are you a Federal Data ... expertise on Medicare..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Pittsburgh Pennsylvania Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..

Job SummaryThe Medical Director, Health Services along with the Vice President, Medical Operations, is directly responsible for all Plan activities related to the member. He/she will be dedicated to the goals ..

Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..

Description The Senior Market Development Professional provides support to assigned health plan(s) relative to Behavioral Health RFPs, product implementations and operational support. The Senior Market Development Professional work assignments involve moderately ..

Description The mission of the Physician Performance Insights team is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain ..

... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..

Job Description In this individual contributor role the Network Management Senior Manager will negotiate, execute, and conducts high level review and analysis, dispute resolution and/or settlement negotiations of contracts with larger ..

Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..